Simultaneous Infection with Enterobacteriaceae and Pseudomonas aeruginosa Harboring Multiple Carbapenemases in a Returning Traveler Colonized with Candida auris

Antimicrob Agents Chemother. 2020 Jan 27;64(2):e01466-19. doi: 10.1128/AAC.01466-19. Print 2020 Jan 27.

Abstract

We report our clinical experience treating a critically ill patient with polymicrobial infections due to multidrug-resistant Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa in a 56-year-old woman who received health care in India and was also colonized by Candida auris A precision medicine approach using whole-genome sequencing revealed a multiplicity of mobile elements associated with NDM-1, NDM-5, and OXA-181 and, supplemented with susceptibility testing, guided the selection of rational antimicrobial therapy.

Keywords: Candida auris; Enterobacteriaceae; NDM; Pseudomonas aeruginosa; carbapenemase; polymicrobial infection.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Bacterial Proteins / genetics*
  • Candida / genetics
  • Candida / isolation & purification*
  • Candidiasis / diagnosis*
  • Candidiasis / microbiology
  • Critical Illness
  • Enterobacteriaceae / enzymology
  • Enterobacteriaceae / genetics
  • Enterobacteriaceae / isolation & purification*
  • Enterobacteriaceae Infections / diagnosis*
  • Enterobacteriaceae Infections / microbiology
  • Escherichia coli / enzymology
  • Escherichia coli / genetics
  • Escherichia coli / isolation & purification
  • Escherichia coli Proteins / genetics
  • Female
  • Humans
  • India
  • Klebsiella pneumoniae / enzymology
  • Klebsiella pneumoniae / genetics
  • Klebsiella pneumoniae / isolation & purification
  • Middle Aged
  • Pseudomonas aeruginosa / enzymology
  • Pseudomonas aeruginosa / genetics
  • Pseudomonas aeruginosa / isolation & purification*
  • beta-Lactamases / genetics*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Escherichia coli Proteins
  • beta lactamase NDM-5, E coli
  • beta-Lactamases
  • beta-lactamase NDM-1
  • beta-lactamase OXA-181, E coli
  • carbapenemase